Provider Demographics
NPI:1831365378
Name:ZAN, MOE T (MD)
Entity type:Individual
Prefix:DR
First Name:MOE
Middle Name:T
Last Name:ZAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:6350 STEVENS FOREST RD STE 101
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21046-3240
Mailing Address - Country:US
Mailing Address - Phone:410-992-7440
Mailing Address - Fax:443-276-0349
Practice Address - Street 1:6350 STEVENS FOREST RD STE 101
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21046-3240
Practice Address - Country:US
Practice Address - Phone:410-992-7440
Practice Address - Fax:443-276-0349
Is Sole Proprietor?:No
Enumeration Date:2008-05-05
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD64424207RR0500X
NH13366207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30209942Medicaid
MD30209942Medicaid
NH30209942Medicaid
MD001897301Medicare PIN